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Hypersexuality is a proposed medical condition said to cause unwanted or excessive sexual arousal, causing people to engage in or think about sexual activity to a point of mental distress or Disability., according to the website of Psychology Today, 2021. Whether it should be a clinical diagnosis used by professionals is controversial. Nymph and Satyr are terms previously used for the condition in women and men, respectively.
Hypersexuality may be a primary condition, or the symptom of other medical conditions or disorders such as Klüver–Bucy syndrome, bipolar disorder, brain injury, and dementia. Hypersexuality may also be a side effect of medication, such as dopaminergic drugs used to treat Parkinson's disease. Frontal lesions caused by brain injury, strokes, and frontal lobotomy are thought to cause hypersexuality in individuals who have suffered these events. Clinicians have yet to reach a consensus over how best to describe hypersexuality as a primary condition, or the suitability of describing such behaviors and impulses as a separate pathology.
Hypersexual behaviors are viewed by clinicians and therapists as a type of obsessive–compulsive disorder (OCD) or obsessive–compulsive spectrum disorder, an addiction,
or an impulse-control disorder. A number of authors do not acknowledge such a pathology, and instead assert that the condition merely reflects a cultural dislike of exceptional sexual behavior.Consistent with having no consensus over what causes hypersexuality, authors have used many different labels to refer to it, sometimes interchangeably, but often depending on which theory they favor or which specific behavior they have studied or researched; related or obsolete terms include compulsive masturbation, compulsive sexual behavior, cybersex addiction, erotomania, "excessive sexual drive", hyperphilia, hypersexuality, hypersexual disorder, problematic hypersexuality, sexual addiction, sexual compulsivity, sexual dependency, sexual impulsivity, and paraphilia-related disorder.
Due to the controversy surrounding the diagnosis of hypersexuality, there is no generally accepted definition and measurement for hypersexuality, making it difficult to determine its prevalence. Thus, prevalence can vary depending on how it is defined and measured. Overall, hypersexuality is estimated to affect 2–6% of the population, and may be higher in certain populations like men, those who have been traumatized, and sex offenders.
Pathogenic overactivity of the dopaminergic mesolimbic pathway in the brain—forming either psychiatrically, during mania, or pharmacologically, as a side effect of , specifically D3-preferring agonists—is associated with various and has been shown to result among some in overindulgent, sometimes hypersexual, behavior. HPA axis dysregulation has been associated with hypersexual disorder.
The American Association for Sex Addiction Therapy acknowledges biological factors as contributing causes of sex addiction. Other associated factors include psychological components (which affect mood and motivation as well as psychomotor and cognitive functions), spiritual control, mood disorders, sexual trauma, and intimacy anorexia as causes or type of sex addiction.
People with bipolar disorder may often display tremendous swings in sex drive depending on their mood. As defined in the DSM-IV-TR, hypersexuality can be a symptom of hypomania or mania in bipolar disorder or schizoaffective disorder. Pick's disease causes damage to the temporal/frontal lobe of the brain; people with Pick's disease show a range of socially inappropriate behaviors.
Several neurological conditions such as Alzheimer's disease, autism spectrum, various types of brain injury, Klüver–Bucy syndrome, Kleine–Levin syndrome, Epilepsy and many neurodegenerative diseases can cause hypersexual behavior. Sexually inappropriate behavior has been shown to occur in 7–8% of Alzheimer's patients living at home, at a care facility or in a hospital setting. Hypersexuality has also been reported to result as a side-effect of some medications used to treat Parkinson's disease. Some recreationally used drugs, such as methamphetamine, may also contribute to hypersexual behavior.
A positive link between the severity of dementia and occurrence of hypersexual behavior has also been found. Hypersexuality can be caused by dementia in a number of ways, including disinhibition due to organic disease, misreading of social cues, understimulation, the persistence of learned sexual behavior after other behaviours have been lost, and the side-effects of the drugs used to treat dementia. Other possible causes of dementia-related hypersexuality include an inappropriately expressed psychological need for intimacy and forgetfulness of the recent past. As this illness progresses, increasing hypersexuality has been theorized to sometimes compensate for declining self-esteem and cognitive function.
Symptoms of hypersexuality are also similar to those of sexual addiction in that they embody similar traits. These symptoms include the inability to be intimate (intimacy anorexia), depression and bipolar disorders.
The resulting hypersexuality may have an impact in the person's social and occupational domains if the underlying symptoms have a large enough systemic influence.
The International Statistical Classification of Diseases and Related Health Problems (ICD-10) of the World Health Organization (WHO), included two relevant entries. One is "Excessive Sexual Drive" (coded F52.7), which is divided into satyriasis for males and nymphomania for females. The other is "Excessive Masturbation" or "Onanism (excessive)" (coded F98.8).
In 1988, Levine and Troiden questioned whether it makes sense to discuss hypersexuality at all, arguing that labeling sexual urges "extreme" merely stigmatizes people who do not conform to the norms of their culture or peer group, and that sexual compulsivity was a myth. However, and in contrast to this view, 30 years later in 2018, the ICD-11 created a new classification, compulsive sexual behaviour disorder, to cover "a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behaviour". It classifies this "failure to control" as an abnormal mental health condition.
Furthermore, those with hypersexuality are more likely to have had or acquire another addiction. Multiple addictions are also prevalent amongst affected individuals. Common co-occurring disorders and addictions hypersexual individuals include eating disorders, compulsive spending, chemical dependency, and uncontrollable gambling.
In addition to this, various questionnaires and instruments may be used to further assess various aspects of an individual's behaviors and symptoms. Some common questionnaires that are used in assessments are the Sexual Inhibition/Sexual Excitation Scale, Intensity of Sexual Desire and Symptoms Scale, Compulsive Sexual Behavior Inventory, Sexual Compulsivity Scale, and the Sexual Addiction Screening Test amongst others. Different instruments can also be used in assessments, including but not limited to the Clinical Global Impression Scale, Timeline Followback, Minnesota Multiphase Personality Inventory II, and the Millon Inventory.
The concept of hypersexuality as an addiction was started in the 1970s by former members of Alcoholics Anonymous who felt they experienced a similar lack of control and compulsivity with sexual behaviors as with alcohol. Multiple 12-step style self-help groups now exist for people who identify as sex addicts, including Sex Addicts Anonymous, Sexaholics Anonymous, Sex and Love Addicts Anonymous, and Sexual Compulsives Anonymous. Some hypersexual men may treat their condition with the usage of medication (such as cyproterone acetate) or consuming foods considered to be . Other hypersexuals may choose a route of consultation, such as psychotherapy, self-help groups or counselling.
Other, mostly historical, names are the Messalina complex, sexaholism, hyperlibido and furor uterinus. John Wilmot, 2nd Earl of Rochester described hypersexuality in some of his literature.
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